14D0959505 CLIA NUMBER - RIVERSIDE MED GROUP CARDIOVASCULAR SPECIALISTS

Laboratory Demographics

  • CLIA Code: 14D0959505
  • Facility Name: RIVERSIDE MED GROUP CARDIOVASCULAR SPECIALISTS
  • Facility Address: 500 N WALL STREET-SUITE C100
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 936-3240
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAY M. HARYANI
  • NPI Number: 1740346451
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 14D0959505
LAB Type Physician Office
Facility Name RIVERSIDE MED GROUP CARDIOVASCULAR SPECIALISTS
Street 500 N WALL STREET-SUITE C100
City KANKAKEE
State IL
ZIP 60901
Phone 815 936-3240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director VIJAY M. HARYANI

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This page was last updated on: 9/29/2025